Bereavement and Loss for people supporting Children

1. Bereavement and Loss for people supporting Children Deborah Boys Learning and Development West Sussex County Council

2. Welcome House keeping • Confidentiality • Mobile Phones • Health and Safety

3. Aims The aim of this course is to help inform your practice when working with children and young people who have experienced a bereavement and loss.

4. A Grief Observed by C.S. Lewis “There is something new to be chronicled every day. Grief is like a long valley, a winding valley where any bend may reveal a totally new landscape. As I’ve already noted, not every bend does. Sometimes the surprise is the opposite one; you are presented with exactly the same sort of country you thought you had left behind miles ago. That is when you wonder whether the valley isn’t a circular trench. But it isn’t. There are partial recurrences, but the sequence doesn’t repeat” (Lewis, 1961:47)

5. Learning & Development Outcomes By the end of this course you will be able to: • Discuss bereavement and loss and what these terms mean • Describe the grieving process and how it impacts on children and young people • Identify the impact of grief and loss on children and young people • Demonstrate an understanding of the child’s journey through grief and how their chronological age affects the process • Initiate strategies for supporting children, young people and their families when experiencing loss

6. Terminology • Bereavement Refers to the state of having lost someone, or indeed something, significant • Grief Usually means the emotional experience that accompanies a significant loss • Mourning Applies to the activities associated with bereavement • Loss applies to the feelings associated with all of the above which may be significant or less so…

7. Bereavement and Loss Significant Loss? • Describe the different types of loss that you have experienced • Identify which types of loss were significant to you and why

8. Bereavement and Loss in Children What are the different types of loss that a child might experience? As a result of divorce or separation A pet A parent Friend(s) Grand parent School Loss of… Transition/ milestones Sibling Home

9. The grief process • Bereavement can occur when there is a significant loss to that person • The significance of the loss is individual to each person • The ways in which people deal with their feelings surrounding loss will also be different

10. Break

11. Factors that can influence bereavement and loss • The timing of the loss • The occurrence of several losses or of loss with other major lifecycle changes • A history of traumatic loss and unresolved mourning • The nature of the death • The significance and function of the person

12. Relationships • Problematic relationships in childhood are particularly damaging. • Mistrust, shame and guilt are linked to young people who have experienced unsupported separation from parents, inconsistent parenting, physical violence, sexual abuse

13. Fahlberg talks about the fact that the consequences of multiple moves in foster care means that children are ‘particularly’ vulnerable to severe problems in the development of social emotions, carrying with it long-term implications for interpersonal relationships, conscience development and self esteem (1994; 138)

14. Current theories of grief and bereavement The notion that a satisfactory outcome in loss or bereavement depends upon emotional expression of grief Sigmund Freud

15. Worden (2003) The process of adjustment to loss commonly known as ‘grief work’using grief counselling and grief therapy (Worden, 2003)

16. The four tasks of grieving • To accept the reality of the loss • To work through the pain of grief • To adjust to the environment without the deceased • To emotionally relocate the deceased and move on with life Worden, 1991

17. Theories of counselling intervention through creation of a safe base in which to explore feelings and concerns. • Attachment theory which promotes security (Holmes, 1993); Person centred approach (Rogers, 1961, 1980), (Ainsworth, 1978)

18. Attachment Theory • Anxious/ Ambivalent attachment • Secure attachment • Avoidant attachment • Overwhelmed loss response and anxious • Balanced/resilient loss response • Controlled loss response

19. Grief theories cont. • The characteristics of grief, particularly as they relate to bereavement are founded in the work of Bowlby (1980); Kubler Ross (1970) and Parkes (1996) collectively known as stage and phase models of grief

20. Stage and phase models • Denial • Despair • Guilt • Anger • Hopelessness • Bargaining • Acceptance • Mourning

21. Sugarman (2001) • Dealing with death and bereavement often obscures the reality that multiple losses are experienced across the life cycle e.g. those that come with developmental change • Some of these ‘little losses’ are rehearsals for more profound encounters with loss and provide a strengthening of emotional and cognitive capacities

22. Sugarman (2001) cont./… • Coping demands are fully tested when relationships or health are damaged or disintegrate and where deeply held aspirations are thwarted or unexpected or traumatic death occurs

23. Stroebe and Schut (1999) Grief as a two dimensional process: • Loss orientation– dealing with the distress of grief • Restoration orientation– focus on diversion from grief and attention to ongoing life demands Successful movement between these two grief modes is necessary to adapt to loss

24. Lazarus and Folkman (1984) • Where internal resources and external sources of support are inadequate for the meeting of loss, vulnerability will result • Recognising loss and the vulnerability it may produce is central to the process of helping a person overcome bereavement and loss

25. Childrenand Young People’s experience Make links to the children you are supporting

26. http:// • http://www.youtube.com/watch?v=Oln5A5ZrSQg Winston’s Wish

27. Lunch

28. Children and their grief experience Factors to consider • The age of the child • Their experience of loss • The child’s coping strategies • The presence and support of family, friends, carers • The child’s mental health and well-being • The child’s understanding about what has occurred

29. The experience of bereavement Bereavement causes a great intensity and variety of emotions which may be felt for many months, if not years, after the death or loss of connection with someone close. In children sometimes these feelings do not manifest until later adulthood.

30. Developmental Grief is… • A grief that returns through memories of that loss. • Grief may return during the holidays or on the anniversary of the loss. Adult adoptees may experience developmental grieving at their own weddings, birth of a child, or graduation; situations that recall the loss of their own birth families. • Children in a foster care situation may experience the same feelings during typical family times, like birthdays or holidays.

31. http://www.youtube.com/watch?v=Qwj2JTCY7Rk • Germaine’s Story Winston’s wish

32. Supporting Children What we do can make the experience of bereavement and loss easier to cope with… • Provide a safe and secure base in which the child feels able to be supported and listened to • Create opportunities for the child to express how they are feeling • Work with the child at their pace and time

33. Divorce and Separation Hints and Tips • If possible and appropriate, assist the child to maintain contact with both parents or main care giver • Encourage the child to talk about their feelings when they wish to • Help the young person to understand that the separation was not their fault • Encourage participation in social activities to help channel any negative energies surrounding separation but recognise that this might be difficult • Help the child to settle into new routines and establish feelings of security • Build on strengths and sense of self worth and identity as individuals

34. Communication • Contact a professional if you feel the sadness is sticking around too long. • Some warning signs to watch for include: • The child loses interest in daily activities and interests • Inability to sleep and loss of appetite. • Acting much younger than chronological age for an extended period of time • Sharp drop in school performance • ‘Acting out’ being out of character for them i.e. exaggerated behaviour

35. Break

36. Activity to promote well being… Treasuring Memories • Making a memory box or a memory book can help children to talk about the person who has died. This also gives children the opportunity to continue to have a relationship with that person

37. Memory Box • If you were supporting a child or young person to make a memory box what are the items that could be put in to it?

38. Remembering • It is important that people are able to talk about and remember someone after they have died. For children, opportunities to remember can assist in maintaining a special relationship with that person, which is likely to have a positive impact on their future emotional development

39. Activities to promote remembering… • Write a letter, Make a card • Take some flowers or a card to the grave • Make a scrapbook • Plant a tree or shrub, bulbs, flowers • Make a CD of favourite tunes • Visit places that make you feel happy • Keep a journal • Talk about the person you are missing with someone who knows them or who is willing to listen

40. Divorce and separation http://www.youngminds.org.uk/for_parents/worried_about_your_child/divorce_separation?gclid=COnAxOOXpLQCFYXLtAodrVUAIQ Feeling Angry http://www.youngminds.org.uk/assets/0000/0720/Feeling_Angry_.pdf Explaining divorce to young children http://www.sesamestreet.org/parents/topicsandactivities/toolkits/ divorce and Separation

41. Anger (podcast) http://www.youngminds.org.uk/assets/0000/0427/070903_YM_Anger.mp3

42. Bereavement and Loss • Cancer and Leukaemia in Childhood (CLIC) www.clic.org.uk • The Child Bereavement Trust www.childbreavement.org.uk • Sargent Cancer Care for Children www.sargent.org • Winston’s Wish (for bereaved children) www.winstonswish.org.uk • Little children, big challenges: Divorce http://www.sesamestreet.org/parents/ topicsandactivities/toolkits/divorce

43. Bereavement /War/Disaster The Bereavement Manual • http://www.childrenandwar.org/resources/grief-manual/ Uses information and research gathered from children bereaved due to war, natural disasters and trauma. Designed as a multi-cultural resource based on Teaching Recovery Techniques (TRT) which helps the child develop coping strategies to reduce effects of bereavement and loss.

44. Learning Gateway